Abstract：
Prolonged screen time is associated with an increased risk of obesity in adolescents. However, little is known about whether Internet use is also associated with dietary risk factors including consumption of obesogenic foods.
In this study, we examined the associations of leisure-time and study-time Internet use with dietary risk factors in Korean adolescents using nationally representative survey data.
We conducted a cross-sectional analysis among 54,416 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2015. Participants were asked to report the average duration of leisure-time and study-time Internet use, days of skipping breakfast, and frequency of fruit, vegetable, instant noodle, fast-food, chip/cracker, and sugar-sweetened beverage (SSB) intakes. We performed multivariable logistic regression to estimate ORs and 95% CIs for the relations between duration of Internet use and dietary risk factors, accounting for complex survey sampling and adjusting for potential confounders.
Prolonged leisure-time Internet use (≥241 compared with 1-60 min/d) was associated with higher prevalence of frequent skipping breakfast (OR: 1.39; 95% CI: 1.29, 1.49), low intakes of fruits (OR: 1.27; 95% CI: 1.18, 1.36) and vegetables (OR: 1.43; 95% CI: 1.33, 1.55), and high intakes of instant noodles (OR: 1.87; 95% CI: 1.74, 2.02), fast-food (OR: 1.63; 95% CI: 1.49, 1.78), chips/crackers (OR: 1.37; 95% CI: 1.24, 1.52), and SSBs (OR: 1.63; 95% CI: 1.52, 1.75). Prolonged study-time Internet use (≥121 compared with 1-60 min/d) was inversely associated with prevalence of low fruit (OR: 0.94; 95% CI: 0.88, 1.00) and vegetable (OR: 0.91; 95% CI: 0.85, 0.98) intakes but was positively associated with high intakes of instant noodles (OR: 1.10; 95% CI: 1.03, 1.19) and chips/crackers (OR: 1.13; 95% CI: 1.04, 1.23). The overall associations remained consistent in analyses stratified by sex, grade, region, parental co-residence, perceived household income, perceived stress level, physical activity, and obesity status.
Our data suggest that prolonged Internet use, particularly during leisure time, is associated with less healthful dietary behaviors in Korean adolescents. Am J Clin Nutr 2021;114:1791-1801.
In this study, we examined the associations of leisure-time and study-time Internet use with dietary risk factors in Korean adolescents using nationally representative survey data.
We conducted a cross-sectional analysis among 54,416 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2015. Participants were asked to report the average duration of leisure-time and study-time Internet use, days of skipping breakfast, and frequency of fruit, vegetable, instant noodle, fast-food, chip/cracker, and sugar-sweetened beverage (SSB) intakes. We performed multivariable logistic regression to estimate ORs and 95% CIs for the relations between duration of Internet use and dietary risk factors, accounting for complex survey sampling and adjusting for potential confounders.
Prolonged leisure-time Internet use (≥241 compared with 1-60 min/d) was associated with higher prevalence of frequent skipping breakfast (OR: 1.39; 95% CI: 1.29, 1.49), low intakes of fruits (OR: 1.27; 95% CI: 1.18, 1.36) and vegetables (OR: 1.43; 95% CI: 1.33, 1.55), and high intakes of instant noodles (OR: 1.87; 95% CI: 1.74, 2.02), fast-food (OR: 1.63; 95% CI: 1.49, 1.78), chips/crackers (OR: 1.37; 95% CI: 1.24, 1.52), and SSBs (OR: 1.63; 95% CI: 1.52, 1.75). Prolonged study-time Internet use (≥121 compared with 1-60 min/d) was inversely associated with prevalence of low fruit (OR: 0.94; 95% CI: 0.88, 1.00) and vegetable (OR: 0.91; 95% CI: 0.85, 0.98) intakes but was positively associated with high intakes of instant noodles (OR: 1.10; 95% CI: 1.03, 1.19) and chips/crackers (OR: 1.13; 95% CI: 1.04, 1.23). The overall associations remained consistent in analyses stratified by sex, grade, region, parental co-residence, perceived household income, perceived stress level, physical activity, and obesity status.
Our data suggest that prolonged Internet use, particularly during leisure time, is associated with less healthful dietary behaviors in Korean adolescents. Am J Clin Nutr 2021;114:1791-1801.
摘要：
背景：延长屏幕时间与青少年肥胖风险增加相关。然而,关于互联网使用是否也与饮食风险因素有关，包括食用生胖食物，人们知之甚少。
目的：在本研究中，我们使用具有全国代表性的调查数据,研究了韩国青少年的闲暇时间和学习时间互联网使用与饮食风险因素的关系.
方法：我们在2015年基于网络的韩国青年风险行为调查中对54,416名中学生和高中生进行了横断面分析。参与者被要求报告闲暇时间和学习时间互联网使用的平均持续时间，不吃早餐的日子，和水果的频率，蔬菜,方便面,快餐,芯片/饼干，和含糖饮料（SSB）摄入量。我们进行了多变量逻辑回归来估计OR和95％CI之间的关系互联网使用的持续时间和饮食风险因素，考虑复杂的调查抽样和调整潜在的混杂因素。
结果：长时间的闲暇时间使用互联网（≥241与1-60分钟/天相比）与频繁不吃早餐的患病率更高相关（OR：1.39；95％CI：1.29，1.49），水果（OR：1.27;95％CI：1.18,1.36）和蔬菜（OR：1.43;95％CI：1.33,1.55）的摄入量低，方便面摄入量高(OR：1.87；95%CI：1.74，2.02)，快餐（OR：1.63；95%CI：1.49，1.78），芯片/饼干（OR：1.37；95%CI：1.24，1.52），和SSB（OR：1.63；95%CI：1.52，1.75）。长期研究时间的互联网使用（≥121，与1-60分钟/天相比）与低水果（OR：0.94；95％CI：0.88，1.00）和蔬菜（OR：0.91；95％CI：0.85，0.98）的摄入量呈负相关，但与方便面（OR：1.10；95％CI：1.03，1.19）和薯条/饼干（OR：1.04，1.23，95CI：1.13；总体关联在按性别分层的分析中保持一致，grade,区域,父母共同居住，感知的家庭收入，感知压力水平，身体活动,和肥胖状况。
结论：我们的数据表明，长期使用互联网，特别是在闲暇时间，与韩国青少年不太健康的饮食行为有关。AmJClinNutr2021；114：1791-1801。
目的：在本研究中，我们使用具有全国代表性的调查数据,研究了韩国青少年的闲暇时间和学习时间互联网使用与饮食风险因素的关系.
方法：我们在2015年基于网络的韩国青年风险行为调查中对54,416名中学生和高中生进行了横断面分析。参与者被要求报告闲暇时间和学习时间互联网使用的平均持续时间，不吃早餐的日子，和水果的频率，蔬菜,方便面,快餐,芯片/饼干，和含糖饮料（SSB）摄入量。我们进行了多变量逻辑回归来估计OR和95％CI之间的关系互联网使用的持续时间和饮食风险因素，考虑复杂的调查抽样和调整潜在的混杂因素。
结果：长时间的闲暇时间使用互联网（≥241与1-60分钟/天相比）与频繁不吃早餐的患病率更高相关（OR：1.39；95％CI：1.29，1.49），水果（OR：1.27;95％CI：1.18,1.36）和蔬菜（OR：1.43;95％CI：1.33,1.55）的摄入量低，方便面摄入量高(OR：1.87；95%CI：1.74，2.02)，快餐（OR：1.63；95%CI：1.49，1.78），芯片/饼干（OR：1.37；95%CI：1.24，1.52），和SSB（OR：1.63；95%CI：1.52，1.75）。长期研究时间的互联网使用（≥121，与1-60分钟/天相比）与低水果（OR：0.94；95％CI：0.88，1.00）和蔬菜（OR：0.91；95％CI：0.85，0.98）的摄入量呈负相关，但与方便面（OR：1.10；95％CI：1.03，1.19）和薯条/饼干（OR：1.04，1.23，95CI：1.13；总体关联在按性别分层的分析中保持一致，grade,区域,父母共同居住，感知的家庭收入，感知压力水平，身体活动,和肥胖状况。
结论：我们的数据表明，长期使用互联网，特别是在闲暇时间，与韩国青少年不太健康的饮食行为有关。AmJClinNutr2021；114：1791-1801。
